Individual
CODY PACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 POLARIS PKWY STE 230, WESTERVILLE, OH 43082-7989
(614) 533-3354
(614) 533-3496
Mailing address
PO BOX 7527, DUBLIN, OH 43017-0727
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35.146247
OH
Other
Enumeration date
03/26/2019
Last updated
08/26/2022
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